The management of the child patient in the dental office affects not only the quality of care that can be delivered, but influences the patients' future health care behavior. The main objective of the project is to evaluate the effects of the dentists' management strategies on the child's cooperation and fear-related behaviors during the restorative session and on subsequent treatment sessions. The first year of the project has led to the elucidation of different reinforcement strategies used by dentists in the management of their child patients and the effects of these on the childrens' behavior. The self-reported fears, disruptive behaviors, and physiological stress responses of forty children were evaluated prior to treatment, during two sessions which the dentist employed a specific reinforcement strategy involving neutral instructions alone, positive feedback for cooperative behavior, criticism for inappropriate or noncompliant behavior, or both positive and negative feedback. The behavior of the child in a subsequent treatment session was also evaluated. Dentists and observers rated children as to their degree of fear and cooperation. The main finding indicated that children treated by a dentist using either neutral instruction alone, or a combined positive-punishment contingency, were able to improve their behavior during two consecutive dental restorative treatment sessions. All children reported less fear of dentistry with experience in the operatory. The use of punishment for inappropriate behavior tended to produce compliance at the time of application of the strategy, but the children came back more disruptive on the subsequent treatment session.